肿瘤细胞治疗研究
英文原题：Immunotherapy resistance in esophageal cancer: Possible mechanisms and clinical implications.
然而，EC患者免疫治疗的总体缓解率（ORR）低于30%，且大多数初始接受免疫治疗的患者可能随时间推移出现获得性耐药（AR）。
食管癌（EC）是成人中常见的消化道（GI）恶性肿瘤。尽管手术技术联合新辅助放化疗已取得快速进展，但EC患者常在晚期才被诊断，五年生存率仍不令人满意。EC患者预后差、死亡率高，表明迫切需要有效且经过验证的治疗方法。近年来，免疫治疗作为一种治疗实体瘤的新型疗法已成功应用于临床，为癌症患者带来了新希望。多种免疫疗法，如免疫检查点抑制剂（ICIs）、CAR-T 细胞疗法和肿瘤疫苗，已在EC治疗中取得重大突破。然而，免疫治疗在EC患者中的总体缓解率（ORR）低于30%，且大多数初始接受免疫治疗的患者很可能随时间推移出现获得性耐药（AR）。免疫抑制极大地削弱了免疫治疗的持久性和有效性。由于免疫微环境内的异质性以及不同EC个体之间高度差异的肿瘤学特征，EC中免疫治疗耐药的确切机制仍不明确。在这篇综述中，我们概述了EC中的免疫治疗耐药，主要聚焦于当前的免疫疗法以及免疫抑制和免疫治疗耐药背后的潜在分子机制。此外，我们讨论了前瞻性生物标志物和增强免疫治疗效果的新方法，以期为EC免疫治疗提供清晰的认识。
Esophageal cancer (EC) is a common malignant gastrointestinal (GI) cancer in adults. Although surgical technology combined with neoadjuvant chemoradiotherapy has advanced rapidly, patients with EC are often diagnosed at an advanced stage and the five-year survival rate remains unsatisfactory. The poor prognosis and high mortality in patients with EC indicate that effective and validated therapy is of great necessity. Recently, immunotherapy has been successfully used in the clinic as a novel therapy for treating solid tumors, bringing new hope to cancer patients. Several immunotherapies, such as immune checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell therapy, and tumor vaccines, have achieved significant breakthroughs in EC treatment. However, the overall response rate (ORR) of immunotherapy in patients with EC is lower than 30%, and most patients initially treated with immunotherapy are likely to develop acquired resistance (AR) over time. Immunosuppression greatly weakens the durability and efficiency of immunotherapy. Because of the heterogeneity within the immune microenvironment and the highly disparate oncological characteristics in different EC individuals, the exact mechanism of immunotherapy resistance in EC remains elusive. In this review, we provide an overview of immunotherapy resistance in EC, mainly focusing on current immunotherapies and potential molecular mechanisms underlying immunosuppression and drug resistance in immunotherapy. Additionally, we discuss prospective biomarkers and novel methods for enhancing the effect of immunotherapy to provide a clear insight into EC immunotherapy.
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